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General NPI Number Information
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NPI Number | 1508912262
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Entity Type | Organization
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Legal Business Name | WAUKEGAN ILLINOIS HOSPITAL COMPANY LLC
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 11/25/2008
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Provider Practice Location Address
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Address Line | 1050 RED OAK LN
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City | LINDENHURST
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State | IL
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Zip | 60046-4998
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Country | US
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Telephone | 847-360-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 1050 RED OAK LN
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City | LINDENHURST
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State | IL
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Zip | 60046-4998
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Country | US
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Telephone | 847-360-3000
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Fax |
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Authorized Official
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Title or Position | DIRECTOR, BUSINESS SUPPORT
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Name | LAURIE HOLTSFORD
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Credential |
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Telephone | 615-465-7466
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State | IL
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